Should I be concerned about a trans-areola augmentation affecting breastfeeding?

Q:

I had my breast implants with a trans-areola incision which I have regretted all my life. I am now pregnant and extremely worried about complications with breast feeding. I want to know is it just a matter of being unable to breast feed or are there other issues like milk rotting in the glands because it cant flow? What can I do to avoid risks?

A:

Glands that are unable to transmit milk along their ducts (because of previous surgery) will simply stop producing milk and the glands/ducts that are intact will function in their place. You may well be successful in breast feeding, and rotting milk will not be an issue.

A:

The ability to breast feed after surgery is difficult to study but I have women who breast fed after this procedure. A periareolar incision will only pass through about 30-40% of the milk ducts leaving 60-70% intact. The unaltered breast will function normally while the obstructed ducts will not drain and the fluid will be absorbed. I am unaware of any risks other than a compromised ability to breast feed. Many woman who have not had surgery have difficulty breast feeding. Do not worry. There are lactation consultants who will visit you in the hospital to help you with the process. This is a time of joy and you should be looking forward to the experience. For more peace of mind you can talk with a board certified plastic surgeon in your community. Good luck.

A:

The trana-areolar incision likely have interrupted some of the milk ducts in your breasts but there are many more which will function correctly. The ducts affected by the surgery will atrophy and the milk will be absorbed. To minimize the risk of infection (mastitis) developing during breast feeding (something to avoid as it can lead to capsular contracture), be sure to consult with a lactation specialist on how to keep this from happening.

A:

Thank you for your question. First of all, not all women are able to breast feed with or without implants. I personally know five of my patients who breast fed successfully after a periareolar augmentation. The ducts which are divided with a periareolar augmentation come from the lower pole of the breast. Most of the milk glands and ducts are in the central and upper pole of the breast. If you develop mastitis from blocked ducts, this can be treated with warm compresses or occasionally aspirating the milk from the blocked ducts. Talk with the lactation specialist about your concerns. I'm sure they have experience with this situation. There are over 300,000 women who get breast augmentation yearly and many become pregnant after their surgery. You are not alone! Good luck and congratulations with the baby.

A:

Trans-areola Breast Augmentation and Breastfeeding – Trans-areola breast augmentation done in the past should not really affect your ability to breastfeed as this does not usually transect the areola ducts. However, my preference is to not perform a trans-areola breast augmentation, but rather a short, well-hidden inframammary approach for this reason. Also, this is a more visible scar.

A:

Having done hundreds of peri areolar sub mammary implants I have not seen one patient who complained about not being able to nurse their babies and I know of a great many who have successfully nursed their babies. When you make the peri areolar incision you cut straight down and don't really interrupt the breast ducts. You definitely will not have rotting milk and you should be able to nurse your child successfully. Congratulation on you up coming delivery.

A:

The trans-areola incision should not affect breast feeding to any significant extent. The incision may cut through breast tissue and some ducts resulting in some scar tissue, but this should have a minimal effect on your ability to breast feed. Good Luck